Health Through Knowledge

The Serano Group

Monday, June 29, 2009

Great Book on Lyme Borreliosis Published in 1917

Want to know about Lyme borreliosis? Learn everything you can about syphilis.

Project Gutenberg is a wonderful thing. They take books with expired copyrights, use volunteers to convert them into electronic form, and then hope to have copies spread throughout the world. All for free. Knowledge for knowledge’s sake.

We don’t know why Audrey Longhurst, LN Yaddanapudi and the Online Distributed Proofreading Team pulled John Stokes’ book on syphilis off the shelf of Cornell University and put it into Project Gutenberg, but we are glad they did.

Reading Stokes’ book, we were struck by several things:

In 1917, Stokes expected the general public to understand subtle and complex issues.

The level of discourse exceeds most of what is published today for doctors.

The parallels between Lyme borreliosis and syphilis are remarkable.

Syphilis and Lyme borreliosis

Without modern tests, drugs, and insurance codes, early twentieth century medical practice seemed to have the freedom to be perceptive, intelligent, and artful. Granted, syphilis and Lyme borreliosis are different diseases, but the similarities are great. Both are caused by spirochetes, bacteria that branched off early from other bacteria in the evolutionary tree. Both often start with a skin lesion and go into an indeterminate, often lengthy, period of quiescence which can quickly convert to active disease. Both have a special affinity for attacking the nervous system. Both left untreated can have devastating effects, producing many of the same symptoms: severe heart disease, plaques in various blood vessels and organs, dementia, crippling arthritis, pain syndromes, extreme fatigue, and general malaise. Both can cause blindness and deafness. Both can be fatal.

The big difference between the two is that Treponema pallidum, the spirochete that causes syphilis, lives only in humans, unable to tolerate temperature variation more than a few degrees from 98.6º F. It is completely dependent on the chemical and physical environment the human body provides. Borrelia burgdorferi, (Bb), the spirochete that causes L. borreliosis, moves readily between cold-blooded arachnids (ticks) and a wide variety of mammals, birds, and reptiles. With some effort researchers can grow Bb in test tubes, but In contrast the syphilis spirochete can be cultured only in live lab mammals. No one has ever been able to grow it in a test tube or Petri dish.

Persistence

This begs an obvious question: Which of these spirochetes is more likely to end up causing a human infection—the extremely fussy and dependent syphilis spirochete or the extremely adaptable L. borreliosis spirochete? The resourceful L. borreliosis spirochete, in addition to its single chromosome, has more than twenty plasmids, functioning chunks of DNA that it can shed to facilitate genetic recombinations making it extremely adaptable.. It can turn genes on and off in complex patterns to confuse and evade out our immune systems. The spirochete causing syphilis does not have plasmids. It has evolved to prosper solely in the human host, remaining there for years in the individual and for millennia in the species,

It is not in the best interest of parasitic or commensal bacteria—pick the adjective best reflecting you current opinion of the microbe—to kill their host before they have propagated sufficient copies in other hosts for species survival. By necessity, they evolve a life cycle that gives them opportunity to spread to other hosts. For the syphilis spirochete, it needs its host to stay alive long enough to spread to their newborns and sexual partners. L. borreliosis requires a similar lengthy life cycle. If nothing else, it has to make sure its vertebrate host stays alive long enough to infect next years ticks. Ticks are born sterile.

This is a much shorter life cycle than that of the microbial diseases that dominate CDC press releases. Pneumococci bacteria do not have to wait for childbirth or sexual unions to spread to more humans. A sneeze or a crowded elevator ride can do the trick. They live fast and furious lives. The syphilis and Lyme borreliosis spirochetes require slower, more persistent lifecycles spanning years, rather than days, to proliferate. (See Paul Ewald’s works listed below for details.)

That the L. borreliosis spirochete has evolved a strategy of proliferation definitely utilizing ticks, and sexual partners, and offspring is not surprising.

Going Underground

Europeans studied and pondered syphilis for 500 years, from the time Columbus’s sailors brought it to Italy from the New World until Alexander Fleming discovered penicillin, which did a pretty good job of keeping its worst effects dampened. Then, we pretty much forgot about syphilis and stopped paying it much attention. A side note: some recent research is beginning to ask what is going on with syphilis in our twenty-first century world of AIDS and a microbial ecosystem transformed by sixty years of antibiotic use. As just one issue, did syphilis really almost vanish when the AIDS epidemic appeared or did we just stop looking for it?

The important point is that researchers stopped observing and thinking much about spirochetes after 1950. They did finally investigate a borreliosis epidemic in the 1970s near Old Lyme, Connecticut, but it took a German expatriate researcher familiar with syphilis, Willy Burgdorfer, to identify its spirochetal cause. Unfortunately, the initial academic researchers followed standard medical-scientific procedure: simplify case definition, promote rote treatment, and devote research to supporting foregone conclusions. Little true insight has been gained since. L. borreliosis was force-fit into the modern model of assembly-line medicine where medical-industrial complex wants to treat doctors like technicians. Doctors are told to run a blood test and prescribe the drug indicated by the test results. If that does not work, they are pressured to extract themselves from the case at hand.

A commercial vaccine or test kit, hopefully one generating a continuous revenue stream, would have been another solution fitting into the modern medical model. But test development and vaccine attempts which dominated L. borreliosis research have been colossal failures. The tests are not acceptably accurate and the vaccines did not keep people from getting sick. In fact, they often made people sick. As for the tests still in use, doctors just assume they mean more than they actually do. None meet acceptable standards for sensitivity.

Very few researchers have closely studied humans with L. borreliosis. Fewer still have applied sufficient critical, comprehensive thinking to the problem.

Returning to the Light

John Stokes closely studied humans with syphilis. His analysis and insight teaches expands what we know about spirochetal disease. Read past his discussion of mercury and arsenic treatments, substituting "antibiotics" and you will learn much. Apply Stokes knowledge and insight of syphilis to L. borreliosis. and you will come away with a clear-minded, rational concept of spirochetal infections, something much different from what today’s textbooks say about Lyme disease.